This invention relates to methods and apparatus for improving the functioning of a patient's heart, and more particularly to improving the functioning of a patient's mitral or tricuspid valve by adding at least one chordal attachment from at least one leaflet of the valve to the wall of the associated ventricle.
International patent application publication WO 2006/078694 A2, entitled “Thorascopic Heart Valve Repair Method and Apparatus” (“the '694 reference”), shows methods and apparatus for repairing a heart valve, e.g., by entering the heart thorascopically through the apex of the heart. The thorascopic instrument is used to engage a leaflet of a heart valve (e.g., the mitral valve) and to pass a suture through the leaflet. The instrument is then retracted from the heart, and the suture (which is still attached to the leaflet) is anchored to the wall of the heart. The suture, which thus now extends from the leaflet to the wall of the heart, acts as a chorda-like attachment or tether, replacing native ruptured or elongated chordae. This can help improve performance of the valve, e.g., by reducing or eliminating leaflet prolapsing and/or by improving coaptation of the leaflets when, during its operating cycle, the valve is supposed to optimally open and close.
An objective of the '694 reference is to perform the heart repair shown without stopping the patient's heart and by means that are less invasive than a full sternotomy and an open heart. By performing the procedure on a beating heart, an objective can be to adjust the length of the replacement suture or tether during the procedure to achieve the best valve performance. The '694 reference employs additional external equipment for functioning (e.g., external light sources, external power sources, external monitor display, external camera and camera coupler, external fiber optic strands extending beyond the instrument handle, etc.).
There are various respects in which it may be possible to improve on what is shown in the '694 reference.